The efficacy and equity of retransplantation: an experimental survey of public attitudes.

Journal Article (Journal Article)


To measure the relative importance people place on prognosis and retransplantation status in allocating scarce transplantable livers.


138 subjects were asked to distribute scarce livers amongst transplant candidates with either a 70% chance or a 30% chance of surviving if transplanted. In one group of subjects, the prognostic difference was based on the presence or absence of a 'blood marker.' In the other group, the prognostic difference was based on whether candidates had been previously transplanted or not, with retransplant candidates having a 30% chance of surviving if transplanted.


Subjects answering the retransplantation survey gave a higher percentage of organs to the better prognostic group than subjects answering the blood marker survey, with a mean of 71.6% versus 65.0%, although this difference fell just short of statistical significance (P = 0.0581). Retransplantation survey respondents were significantly less likely to want to ignore prognostic information than were blood marker respondents (P = 0.026). Subjects in both survey groups were equally unwilling to abandon the poor prognostic group, with only 18% in each group choosing to give all the available organs to the better prognostic group.


Respondents reacted more strongly to prognostic differences when they were due to retransplant status than to the results of a blood test. However, most people were not solely interested in the aggregate medical benefit brought by different allocation systems, but were also interested in the amount of benefit brought to the worst off.

Full Text

Duke Authors

Cited Authors

  • Ubel, PA; Loewenstein, G

Published Date

  • November 1995

Published In

Volume / Issue

  • 34 / 2

Start / End Page

  • 145 - 151

PubMed ID

  • 10153483

Electronic International Standard Serial Number (EISSN)

  • 1872-6054

International Standard Serial Number (ISSN)

  • 0168-8510

Digital Object Identifier (DOI)

  • 10.1016/0168-8510(95)00714-4


  • eng